Ritalin

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

PATIENT INFO

Patient Name:

Medical Record #:

BD: / / Sex: F M

PHYSICIAN INFO

Physician Name :

Address:

Ph: ( ) - Fax: ( ) -

Additional Report to:

Ph: ( ) - Fax: ( ) -

TESTS REQUESTED
Test Name:	ICD9 Code: (required)
1. Ritalin
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

RITAL

Test Workstation :

MAYO

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube

Alternate Tube Type:

Sodium Heparin (green top)

Collection Volume:

5.0 mL

Minimum Volume:

1.5 mL

Storage:

Frozen

Availability:

Sent to reference lab

Methodology:

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Special Instructions:

Do not use serum separator tubes. Remove serum from cells ASAP and freeze. Days Performed: MonSun

Lab/Phone:

330-543-8418

TAT:

5-13 days

Additional Info:

Reference range: 5.0-20.0 ng/mL

CPT Code:

80360

Synonyms:

Methylphenidate

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Ritalin

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

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